加拿大温哥华男男性行为者对非职业性暴露后预防的认知与使用情况
Awareness and use of nonoccupational post-exposure prophylaxis among men who have sex with men in Vancouver, Canada.
作者信息
Lin S Y, Lachowsky N J, Hull M, Rich A, Cui Z, Sereda P, Jollimore J, Stephenson K, Thumath M, Montaner Jsg, Roth E A, Hogg R S, Moore D M
机构信息
British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada.
Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
出版信息
HIV Med. 2016 Oct;17(9):662-73. doi: 10.1111/hiv.12369. Epub 2016 Aug 1.
OBJECTIVES
Nonoccupational post-exposure prophylaxis (nPEP) is a strategy to reduce the risk of HIV infection in those with high-risk exposure. This study characterized nPEP awareness among gay, bisexual and other men who have sex with men (MSM) in Metro Vancouver, British Columbia, Canada after a pilot nPEP programme established in 2012.
METHODS
Momentum Health Study participants were MSM aged ≥16 years recruited via respondent-driven sampling (RDS) who completed a computer-assisted self-interview. Stratifying patients by HIV status, we used multivariable logistic regression with backward selection to identify factors associated with nPEP awareness. All analyses were RDS-adjusted.
RESULTS
A total of 51.9% (112 of 173) of HIV-positive and 48.5% (272 of 500) of HIV-negative participants had heard of nPEP. Only 3% (five of 106) of HIV-negative participants who reported recent high-risk sex used nPEP. Generally, nPEP awareness was higher for participants who engaged in sexual activities with increased HIV transmission potential. Factors associated with greater awareness among HIV-negative participants included recent alcohol use, higher communal sexual altruism, previous sexually transmitted infection diagnosis, and greater perceived condom use self-efficacy. Other factors associated with greater awareness among HIV-negative participants included white race/ethnicity, gay sexual identity, more formal education, lower personal sexual altruism, and Vancouver residence. Greater nPEP awareness among HIV-positive participants was associated with greater perceived agency to ask sexual partners' HIV status and more frequently reporting doing so, a higher number of lifetime receptive sex partners, and greater access to condoms.
CONCLUSIONS
Following implementation of an nPEP pilot programme, nPEP awareness among HIV-negative MSM was 51% and use was 3%. These data support the need to expand access to and actively promote nPEP services.
目的
非职业性暴露后预防（nPEP）是一种降低高危暴露人群感染艾滋病毒风险的策略。本研究描述了在2012年设立试点nPEP项目后，加拿大不列颠哥伦比亚省大温哥华地区男同性恋、双性恋和其他与男性发生性行为者（MSM）对nPEP的知晓情况。
方法
动力健康研究的参与者为年龄≥16岁的MSM，通过应答驱动抽样（RDS）招募，他们完成了计算机辅助自我访谈。我们按艾滋病毒感染状况对患者进行分层，使用多变量逻辑回归和向后选择来确定与nPEP知晓情况相关的因素。所有分析均进行了RDS调整。
结果
共有51.9%（173人中的112人）的艾滋病毒阳性参与者和48.5%（500人中的272人）的艾滋病毒阴性参与者听说过nPEP。在报告近期有高危性行为的艾滋病毒阴性参与者中，只有3%（106人中的5人）使用了nPEP。一般来说，参与具有更高艾滋病毒传播可能性性行为的参与者对nPEP的知晓率更高。与艾滋病毒阴性参与者中知晓率更高相关的因素包括近期饮酒、更高的群体性利他主义、既往性传播感染诊断以及更高的自我感知避孕套使用效能。与艾滋病毒阴性参与者中知晓率更高相关的其他因素包括白人种族/族裔、男同性恋性取向、受教育程度更高、个人性利他主义较低以及居住在温哥华。艾滋病毒阳性参与者中更高的nPEP知晓率与更高的自我感知询问性伴侣艾滋病毒感染状况的能力以及更频繁报告这样做、终身接受性行为伴侣数量更多以及更容易获得避孕套有关。
结论
实施nPEP试点项目后，艾滋病毒阴性MSM中nPEP的知晓率为51%，使用率为3%。这些数据支持扩大nPEP服务的可及性并积极推广该服务的必要性。
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